MRS. MARYKAY POWELL (NPI# 1154714418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154714418 |
| Entity Type | Individual |
| Full Name | MRS. MARYKAY POWELL |
| Credential | ADDICTIONS COUNSELOR |
| Practice Address |
4175 Cedar Ln Medford OR 97501-9611 |
| Practice Telephone | 5416907009 |
| Mailing Telephone | 5416907009 |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2020-09-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
20-05-16 | OR | Behavioral Health & Social Service Providers |
| N | 175T00000X | Peer Specialist | OR | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | MHACBO | 20-05-16 | 01 |
| Street Address |
4175 CEDAR LN |
| City | MEDFORD |
| State | OR |
| Zip Code | 97501-9611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366069494 | Brian Snapp | Counselor | 1191 Hazel St, Medford, OR 97501 | 2020-07-06 |
| 1477174761 | Corey Renfree | Counselor | 1191 Hazel Street, Medford, OR 97501 | 2020-04-28 |
| 1669012928 | One of A Kind Therapy LLC | Social Worker | 916 West 10th St #205, Medford, OR 97501 | 2020-01-14 |
| 1265993620 | Star Dialysis LLC | Clinic/Center | 50 Rossanley Dr, Medford, OR 97501 | 2019-03-28 |
| 1962972463 | Karen Elise Roertgen | Counselor | 328 So. Central Ave., Suite 204, Medford, OR 97501 | 2018-11-28 |
| 1316458813 | Rick's Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 562 Parsons Drive, Suite 114, Medford, OR 97501 | 2017-10-24 |
| 1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
| 1992229009 | Cassandra Schultz | Massage Therapist | 824 East Jackson, Suite A, Medford, OR 97501 | 2017-07-31 |
| 1972962355 | Robin Clevenger | Peer Specialist | 301 S Ivy St, Medford, OR 97501 | 2016-02-15 |
| 1154706984 | Debbie Diane Orr | Behavioral Analyst | 1024 West 9th Street, Medford, OR 97501 | 2015-07-22 |
| Find all providers in zip 97501 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124685870 | Tracy L Sunde | Counselor | 512 4th St Sw, Medford, MN 55049-9568 | 2019-05-28 |
| 1245737956 | Larkspur Counseling LLC | Counselor | 328 S Central Ave Ste 212, Medford, OR 97501-7274 | 2018-04-09 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1255875654 | Danielle E Peterson | Counselor | 429 W Broadway Ave, Medford, WI 54451-1608 | 2016-12-05 |
| 1376099523 | Patricia Mcatee | Counselor | 243 N Holly St, Apt 1, Medford, OR 97501-5603 | 2016-08-28 |
| 1437512449 | Sage Bosch | Counselor | 1003 E Main St # 104, Medford, OR 97504-7448 | 2016-03-29 |
| 1114385853 | April Collins-macauley | Counselor | 234 W 5th St, Medford, OR 97501-2611 | 2016-02-09 |
| 1699163931 | Violeta Iguchi | Counselor | 3501 Excel Dr Ste 225, Medford, OR 97504-8067 | 2015-01-08 |
| 1790109049 | Ellen Lynch | Counselor | 3251 Route 112 Ste 2, Medford, NY 11763-1446 | 2014-02-06 |
| 1922429174 | Roderick Evans | Counselor | 107 E Main St Ste 11, Medford, OR 97501-6022 | 2013-12-13 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.